Whenever assistance is provided to mitigate the risks faced by a community, the first step is to assess rapidly what is needed in terms of priorities, personnel and resources. External support agencies have three distinct phases of assistance: public health assistance during hostilities, assisting the transition to peace and ongoing post-war protection. The challenge facing the international community of aid organizations and bilateral bodies is to minimize the problems as rapidly as possible in the context of the situation prevailing at the time.
In recent years there have been a substantial number of severe natural disasters. In addition, the end of the Cold War has meant a proliferation of international man-made emergencies that collectively have translated into a period of extensive and intensive humanitarian relief activities. However, relief operations are often stretched because of a lack of resources, and despite such efforts, there remains a continuing trend towards increasing numbers and intensities of emergency situations around the World.
Agreed approaches and methods have been lacking among donor governments and other external support agencies providing assistance in environmental and health matters to communities experiencing the ravages of armed conflict. As a result, the efficiency and effectiveness of the limited aid resources available have been impaired. Cooperative agreements among external support agencies are most urgently needed in the following areas: (a) A standardized response programme needs to focus on priority environment and health issues in each locality being served; (b) A standard approach to field assessment of the environment and health situation needs to be used, especially in the initial period of intervention; (c) A standardized format for data collection and a minimum set of criteria for assessment would greatly reduce the risk of ambiguity and incomparability of the different types of assessment performed at present by different entities; (d) A logical extension of this standardized approach to field assessment would be to develop the concept of a central clearinghouse in a conflict zone for matching requests for assistance with offers from donors; (e) A mechanism is needed for coordinating external assistance entities that would begin to function at the outset of a humanitarian crisis. Coordination would focus on avoiding duplication and providing aid to the most severely affected localities; and (f) An international agreement is needed to limit increases in the destructive power of hand-held conventional weapons. In future armed conflicts, this would reduce damage to environment and health facilities and services and also reduce adverse health effects among the affected populations. This is a logical extension of the recent international agreement to eliminate land mines. A first step would be to convene an international forum to examine this initiative in greater detail.
The deliberate targeting and destruction of health care establishments and environment and health facilities by combatants should be specified as a category of war crimes. This would reduce adverse health effects on the population in future armed hostilities.
The intensity and numbers of international emergencies have been rising considerably in recent years, prompting all or most humanitarian agencies to upgrade their activities, further stretching their capacities to respond to them.
More than 30 million refugees fleeing war, famine or persecution have received aid from the UN High Commissioner for Refugees (UNHCR) since 1951 in a continuing effort coordinated by the United Nations that often involves other agencies. In recent years, the number of people needing assistance from the UN High Commissioner for Refugees (UNHCR) has risen greatly, as a result of a focus by warring factions in many parts of the World on civilian targets as part of their military strategy. In 1983, 11 million refugees were recognized by UNHCR, whilst the number had risen to 19 million ten years later. A further 24 million people or more were displaced within their country of origin during 1993, and UNHCR activities have increasingly focused on this group of people. In 1994 there are more than 19 million refugees, primarily women and children, who are receiving good, shelter, medical aid, education and repatriation assistance. New conflicts in Angola, Burundi, Rwanda, Georgia, Ngorno-Karabakh and other countries have required UNHCR to provide assistance to many more refugees.
In both the storage and dispatching of relief supplies, the capacities of the UN operational agencies are required. The UN Children's Fund (UNICEF) plays an important role, and has provided considerable relief assistance through the UNICEF Procurement and Assembly Centre (UNIPAC) warehouse facility in Copenhagen. The DHA has also made substantial use of its warehouse in Pisa, Italy, which serves as an efficient instrument to dispatch and store urgent relief supplies. Since operation began in 1987, 223 shipments, totalling over 5,000 tonnes of relief goods have left Pisa for 67 countries. DHA is also working on guidelines for the use of military and defence assets (MCDA) in disaster relief. During 1992 and 1993, DHA assisted the formulation of technical programmes and in channelling external assistance to meet the individual needs of 18 of the most disaster-prone countries, as well as collaborating with non-UN organizations in setting up programmes for countries with similar needs. Over 70 countries have benefited from these programmes.
In 1993, the World Food Programme (WFP), the food agency of the UN, committed 2,5 million tons of food commodities valued at US$1,200 million to 27,7 million disaster victims. Chronic food shortages rose as a result of man-made disasters with increased and sustained levels of conflict and civil strife, whereas there was a sharp fall of drought victims (as a result of the phasing out of the southern Africa drought emergency). Sub-saharan Africa, the former Yugoslavia and the Newly Independent States (NIS) were the main regions for WFP activities. The former Yugoslavia was the year's largest operation, requiring more than half a million tonnes of food for almost 4 million people.
The UN Children's Fund (UNICEF) special responsibility is to ensure that the basic needs of children and their mothers are met, lending itself to reducing their vulnerability to the impact of emergencies. In 1993, UNICEF was involved in 64 emergency operations globally, continuing an upward trend since 1990, when it assisted 29 countries; this number rose to 50 in 1991, and to 54 in 1992. In 1993, Africa remained the continent in greatest need and was afforded highest priority.
In 1993, the World Health Organization (WHO) responded to over 50 emergencies, 28 of those involved complex war and civil strife. Recently adopted resolutions have facilitated WHO to become more involved with humanitarian assistance.
The International Organization for Migration's (IOM) provides administrative and logistical aid to support the migration of people, including displaced persons, and people otherwise vulnerable and in danger.
The International Federation of Red Cross and Red Crescent Societies respond to both natural and man-made disasters by supporting the efforts of National Red Cross and Red Crescent Societies affected by a disaster. These National Societies are present in 161 countries. From 1992 to 1993, relief appeals fell from 54 in 1992 to 31 in 1993, the number of operations moved from 54 to 45, and the number of people assisted fell from 19,408,450 to 15,182,400. However, for the same period the total aid sought increased from 304 to 410 million Swiss francs, reflecting the growing cost, scale, complexity and diversity of disasters worldwide. Assistance to Europe increased greatly because of the needs in the former Soviet Union and the former Yugoslavia.
In 1993, many other humanitarian governmental programmes and NGOs participated in the efforts of the international community to relieve the suffering of disaster victims.
Relief operations are invariably hampered by slow deployment and a breakdown in neutrality; there is more and more need for military protection of humanitarian operations; voluntary agency staff are too young and inexperienced and have no institutional memory.